Healthcare Provider Details

I. General information

NPI: 1992687537
Provider Name (Legal Business Name): SOLENE PSYCHIATRY AND PERFORMANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 HAMPTON ST STE 2B4
COLUMBIA SC
29201-2865
US

IV. Provider business mailing address

1201 HAMPTON ST STE 2B4
COLUMBIA SC
29201-2865
US

V. Phone/Fax

Practice location:
  • Phone: 864-993-4297
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH LANGLEY MARTINEZ
Title or Position: PSYCHIATRIST
Credential: DO
Phone: 803-970-6655